I’m an intern doctor who started my residency in June, and I’m in a tough spot. According to HR, I chose a health insurance plan in the first week of June but didn’t “confirm” it. Apparently, I was supposed to go back and confirm it in early July. I’ve been working over 80 hours a week and didn’t have the time or energy to deal with their weekly reminders. I thought I was set after selecting my insurance.
I just found out I’m not covered when I tried to get a routine vaccine. What can I do now? I’m working hard to resolve this with my employer, but I doubt they’ll change their stance.
I’m considering a strategy but want to stay within the rules. Open enrollment is in November. Can I sign up for marketplace insurance and then cancel it right away to enroll with my employer? HR mentioned that losing insurance for any reason is a qualifying event. If I cancel because it doesn’t meet my healthcare needs, is that acceptable? Please help!
You probably don’t qualify for any special election periods, so you’ll need to go without coverage for the next few months. However, you might be able to purchase a non-qualifying catastrophic plan in the private market to cover yourself until the new plan year begins.
Yes, you are outside the timeframe for a qualifying life event (QLE) for losing your prior insurance. By not clicking “confirm,” you missed your opportunity. I understand it doesn’t seem fair.
Did you start your residency as a new hire and complete the new hire enrollment? If that’s the case, when does your employer’s annual open enrollment occur? Is it in November for a plan that starts in January, or does it happen at another time?
Yes, open enrollment for ACA/marketplace plans starts on November 1 for plans that take effect on January 1, 2025.
Here’s an unethical life pro tip: One hospital employer accepted “began using tobacco” as a qualifying life event (QLE). Seriously. A colleague started smoking to change their benefits. Your mileage may vary. Be sure to ask your benefits department to clearly list what qualifies as a QLE.